Provider Demographics
NPI:1386607372
Name:ASESOR, MARIA CONCEPCION (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:CONCEPCION
Last Name:ASESOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:CONCEPCION
Other - Last Name:DELUNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1500 N BEAUREGARD ST
Mailing Address - Street 2:STE 110
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1715
Mailing Address - Country:US
Mailing Address - Phone:703-370-9002
Mailing Address - Fax:703-370-2849
Practice Address - Street 1:4660 KENMORE AVE
Practice Address - Street 2:SUITE 710
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1313
Practice Address - Country:US
Practice Address - Phone:703-370-9002
Practice Address - Fax:703-370-2849
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101057253207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA110221045OtherRR MEDICARE
VA110221045OtherRR MEDICARE
VA013660N03Medicare PIN